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Q J Med 1966; 35: 193-214
© 1966 Association of Physicians

research-article

CUSHING'S SYNDROME: ADRENOCORTICAL HYPERACTIVITY SECONDARY TO NEOPLASMS ARISING OUTSIDE THE PITUITARY-ADRENAL SYSTEM

M. FRIEDMAN, P. MARSHALL-JONES and E. J. ROSS

Medical Unit and Metabolic Ward, University College Hospital and Medical School London, W.C.1

Received 18 July 1965 Nine cases of Cushing's syndrome associated with non-adrenal-pituitary malignant neoplasms are described. The findings are compared and contrasted with 50 cases of non-malignant Cushing's syndrome previously described. In eight cases the primary carcinoma was bronchogenic in origin, whereas in one ease the primary arose in the parathyroid glands. Eight of the nine cases pre sented with a hypokalaemie alkalosis and all were found to have markedly elevated urinary 17-ketogenic steroids and plasma 1l-hydroxycorticosteroids, both at 9 a.m. and at 12 midnight. The possible mechanisms producing excess adrenocortical activity are considered. The therapeutic approach to the management of cases with the syndrome is briefly discussed.


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